A short history of gout

Timeline

1. Ancient Egypt

   The earliest records

   A history review in Arthritis Research & Therapy says gout was first identified by the Egyptians, dating it to 2640 BC.

2. 5th century BC

   Hippocrates and podagra

   Hippocrates described podagra, gout in the big toe joint, and called it “the unwalkable disease.” His aphorisms say gout flares in spring and autumn and that the inflammation settles within 40 days. Some of his other claims about who gets gout were wrong.

3. 2nd century AD

   Galen describes tophi

   The Greek physician Galen was the first to describe tophi, the lumps we now know are urate crystal deposits. He blamed a thick, crude humor settling in the joint.

4. 6th century AD

   Autumn crocus

   The Byzantine physician Alexander of Tralles is credited with first using colchicum, from the autumn crocus, as a specific gout treatment. Colchicine comes from this plant. It was known even then to cause serious stomach and gut side effects.

5. 13th century

   The word “gout”

   A Dominican monk, Randolphus of Bocking, is the first person known to use the word. It comes from the Latin gutta, “drop.” In those days people thought an excess of one of the four humors dripped into a joint and caused pain.

6. 1679

   Van Leeuwenhoek sees crystals

   In a letter dated July 11, 1679, the microscope pioneer Antoni van Leeuwenhoek described chalky matter from a gouty tophus. Under his lens it was made of long, clear, needle-like particles. Nobody yet knew what they were made of.

7. 1683

   Sydenham’s description

   The English physician Thomas Sydenham, who had gout himself, wrote a classic account of a flare. He described pain in the big toe that wakes you around two in the morning and becomes too painful to bear even the weight of the bedclothes.

8. 1776 and 1797

   Uric acid is found

   In 1776 the Swedish chemist Carl Wilhelm Scheele identified a new acid in urinary stones, later named uric acid. In 1797 the English chemist William Hyde Wollaston reported finding the same substance in gouty deposits. Histories say the sample came from a tophus in his own ear.

9. 1848 to 1859

   Garrod’s thread test

   Alfred Baring Garrod showed that people with gout had too much uric acid in their blood. His “thread test” let uric acid crystals form on a linen thread. In his 1859 book he argued that the deposited urate causes the inflammation, not the other way around.

10. 1950s

    Probenecid

    Medicines that help the kidneys clear urate were first tried in the late 1800s. In the early 1950s probenecid, then sold as Benemid, was studied in gout. It is still prescribed today. See Medicines, by name.

11. 1961

    Crystals under polarized light

    Daniel McCarty and Joseph Hollander reported urate crystals in joint fluid from people with gout, using polarized light microscopy. Looking for crystals in joint fluid became a key way to confirm gout. More on that is on How gout is diagnosed.

12. 1963 (Nobel Prize 1988)

    Allopurinol

    Gertrude Elion and George Hitchings developed allopurinol in 1963. It lowers how much uric acid the body makes. Their wider work on drug design earned a share of the 1988 Nobel Prize in Physiology or Medicine.

13. 2009 and 2010

    Febuxostat and pegloticase

    The FDA approved febuxostat on February 13, 2009. On September 14, 2010, it approved pegloticase, an infused enzyme, for chronic gout in adults when usual treatment has not worked or cannot be used.

The “disease of kings”

For centuries gout was tied to rich food, alcohol, and a life only the wealthy could afford. Hippocrates called it an arthritis of the rich. In some eras it was almost a status symbol.

• William Pitt the Elder

  The British statesman had disabling gout. Historians link his absences from Parliament to the tax fights before the American Revolution.

• Benjamin Franklin

  Franklin had severe gout and wrote a comic piece about it, Dialogue Between Franklin and the Gout.

• Doctors and scientists

  Thomas Sydenham, William Wollaston, and the physician William Stukeley all had gout and wrote about it.

• Not just the rich

  The same review notes that gout has become more common worldwide. Today it is not a mark of wealth, and having it is not a moral failing.

What people tried in the past

History only. None of these is recommended, and some were dangerous.

• Bloodletting

  Galen called for bleeding from a vein at the elbow, sometimes repeated, to drain the “humor.”

• Purging and vomiting

  Purges, enemas, and emetics were meant to flush the humor out. Ancient Greek writers also used colchicum as a strong purgative.

• Fasting and strict diets

  Hippocratic writers prescribed fasting and liquid diets. They also told patients to give up wine. Later writers urged cutting meat and alcohol and living on milk.

• Spa waters and baths

  In the 1700s, many books on gout discussed bathing in mineral waters along with diet.

• Flannel and sweating

  One 1750 regimen said to wrap the limbs in flannel, stay in a warm bed, and keep up sweating, so the “gouty matter” would stay in the limbs.

• Odd mixtures and opium

  The same regimen listed powders made from crab claws, coral, and pearl, plus laudanum, an opium mixture. Hippocratic writers used opium poppy too.

• Huge doses of salicylates

  In 1877 a doctor used very large amounts of salicylates, relatives of aspirin, to clear urate. This was dropped because it was toxic and impractical.

• “Gout protects you”

  Some 18th-century writers believed a gout attack warded off worse illness and lengthened life. That was a belief of the time, not a finding.

What it means today

Sources

A concise history of gout and hyperuricemia and their treatment

Nuki G, Simkin PA. Arthritis Research & Therapy (PMC review). Egypt, Hippocrates and his aphorisms, Galen and tophi, the word “gout,” Sydenham, Leeuwenhoek, Scheele, Wollaston, Garrod, McCarty and Hollander, colchicum and Alexander of Tralles, uricosurics, salicylates, probenecid, allopurinol, the “disease of kings,” Pitt, Franklin, and Walpole. Accessed October 12, 2026.

Gout from the Corpus Hippocraticum to the Renaissance: the role of Galen

PubMed abstract. Galen’s humoral view of tophi, and his use of bloodletting, purges, enemas, emetics, and poultices. Accessed October 12, 2026.

Gout in the “Anonymus Parisinus”

PMC review summarizing Hippocratic treatment: opium poppy, fasting, liquid diet, purges, and giving up wine. Accessed October 12, 2026.

Some historical remarks on microcrystalline arthritis (gout and chondrocalcinosis)

Reumatismo, 2011. Scheele (1776), Wollaston (1797), Leeuwenhoek, and Garrod’s 1848 work and 1859 thread method. Accessed October 12, 2026.

Leeuwenhoek letter L-090, July 11, 1679

Lens on Leeuwenhoek, with the English text in the Collected Letters at DBNL. Accessed October 12, 2026.

Wollaston WH. On gouty and urinary concretions

Philosophical Transactions of the Royal Society, 1797. Accessed October 12, 2026.

McCarty DJ, Hollander JL. Identification of urate crystals in gouty synovial fluid

Annals of Internal Medicine, March 1961;54:452–460. Accessed October 12, 2026.

The Nobel Prize in Physiology or Medicine 1988, press release

NobelPrize.org. Elion and Hitchings, and allopurinol developed in 1963. Accessed October 12, 2026.

FDA: pegloticase (Krystexxa) approval record

Marketing approval September 14, 2010. Accessed October 12, 2026.

Takeda: FDA approves Uloric (febuxostat)

Company announcement of the February 13, 2009 FDA approval. Accessed October 12, 2026.

Rules for gouty people: eighteenth-century advice

Royal College of Physicians Museum, 2023. Mineral-water bathing and diet in gout books, and Thomas Short’s 1750 regimen. Accessed October 12, 2026.

Franklin B. Dialogue Between Franklin and the Gout

Project Gutenberg. Accessed October 12, 2026.